Tag: Dobbs

HHS Probe Into States’ Medicaid Coverage of Abortion Care: Will Abortion Care Policies Truly be Left up to the States in the Wake of Dobbs?

In 2022, the Supreme Court, in Dobbs v. Jackson Women’s Health Organization overturned Roe v. Wade, holding that abortion care is not a fundamental right under the Constitution. Therefore, access to abortion care is now left up to the states. However, the Trump Administration has also signaled that the current United States Department of Health and Human Services’ (HHS) priorities must protect the right of religious exercise and has expressed a goal to reevaluate programs to ensure enforcement of the Hyde Amendment, which prevents federal funds from being used for elective abortions. The Administration’s statements have created questions about whether future abortion care policies will actually be left to the states. 

On March 19, 2025, HHS’s Office of Civil Rights announced that it plans to investigate thirteen states, including California, Colorado, Illinois, Maine, Minnesota, New York, Maryland, and Massachusetts, for allegedly compelling health care providers to provide abortion care. While the full list of the states under investigation has not been released, the states included are those that mandate state-regulated health insurance plans to cover abortion care. The actions are being taken under the Weldon Amendment that prohibits states from discriminating against health care providers that refuse to cover abortion. The Biden Administration interpreted the amendment not to apply to healthcare sponsors, but this administration believes that interpretation is too limited. While the Trump Administration had previously rescinded civil rights guidance issued by the Biden Administration that largely sought to protect abortion access, this investigation has escalated efforts to limit abortion care. 

Maryland Governor Wes Moore and Massachusetts Governor Maura Healey have publicly responded to the letters they received from HHS and both made clear that their priorities are to continue ensuring access to reproductive health care in their states. While it remains unclear what the outcome of these investigations will be, they indicate a potential threat to states that have decided to continue ensuring access to abortion. Reproductive health care advocates have expressed a concern that this investigation indicates that the Trump Administration does not truly intend to “leave abortion to the states” and that further federal interference with states that have protected abortion access post-Dobbs may be imminent. In addition, concerns have arisen that the investigations do not have weight under law, as they did not arise out of any complaints of the states, and advocates have expressed fear that they have merely arisen to advance the Administration’s political agenda, rather than out of a genuine concern of violation of the law. For citizens, abortion care post-Dobbs has been uncertain, with access largely depending on geography and an increase in travel for abortion access. This investigation indicates the potential that the Trump Administration plans to take action to further limit abortion access, particularly meaning that low-income citizens with less ability to travel may experience further difficulty in access. 

Criminalizing Miscarriage: How the Law Penalizes Grieving Mothers

Miscarriage—pregnancy loss prior to twenty weeks gestation—occurs in as many as one in five known pregnancies. Most of these occur in the first thirteen weeks, with chromosomal abnormalities accounting for nearly half of the miscarriages that occur in the first trimester. Treatment options include expectant management, medication, and surgical intervention, with 70-80% of mothers being able to pass a miscarriage naturally without medication or surgery. That means, with up to one million mothers experiencing miscarriage annually in the U.S. alone, over 700,000 of them are managing that loss from their own homes. Studies accounting for race have shown that black women are disproportionately affected with almost twice as much risk of miscarriage as other ethnic groups.

In the first year after the Dobbs decision, the U.S. saw criminal charges for at least 210 pregnant people related to pregnancy, pregnancy loss, and birth. This number represents a single-year high since researchers began documenting cases. For reference, only around 1,800 pregnancy-related charges were documented in the entire forty-nine years that Roe v. Wade held precedent. Since Dobbs, fetal personhood laws have expanded considerably, with seventeen states now granting fetuses the same level of legal protection as living humans. Lawmakers opposed to these measures have tried to sound the alarm about the risk of criminal charges for miscarrying mothers.

In March of this year, what began as a 911 call for a medical emergency ultimately led to the arrest of Selena Maria Chandler-Scott, a 24-year-old Georgia mother. At 19-weeks pregnant, Chandler-Scott suffered a miscarriage. First responders took her to the hospital after they discovered her unconscious and bleeding in her apartment, but a witness also reported having seen her dispose of fetal remains in the dumpster of their apartment complex. At a time when she was likely experiencing intense grief, Chandler-Scott also had to navigate criminal charges in the days following her pregnancy loss. Though they were ultimately dropped, Chandler-Scott was initially charged with concealing a death and abandonment of a dead body. She was cleared only after the autopsy report showed the miscarriage was naturally occurring.

Brittany Watts, an Ohio woman, faced charges similar to Chandler-Scott’s after miscarrying in October 2023. After hours waiting for the hospital to determine the legality of inducing labor after her water broke prematurely, Watts went home, where she ultimately miscarried naturally. When she returned for further medical treatment after miscarrying a pregnancy that the hospital had already determined was both a significant risk to Watts’s health and nonviable, the hospital reported Watts to the local police department. Unlike Chandler-Scott, however, the determination that the miscarriage was naturally occurring did not clear Watts of criminal charges for abuse of a corpse.  The county prosecutor’s office pressed forward, and Watts was cleared only after a Grand Jury declined to indict her for the fifth degree felony.

In addition to criminal charges, miscarrying mothers also face an increased risk of negative health outcomes in post-Dobbs America. Because of fetal personhood laws, doctors in many states are barred from medically intervening so long as the fetus still has a heartbeat. Under the federal Emergency Medical Treatment & Labor Act (EMTALA), doctors are legally protected for abortion care provided during emergency circumstances. The Supreme Court in 2024 held that state laws cannot preempt this legal protection for preventing “grave harms.” Doctors, however, remain fearful of legal repercussions and often wait before treating pregnant patients.  Kyleigh Thurman was discharged from a Texas hospital without treatment for her ectopic pregnancy, which ruptured days later, resulting in the loss of her fallopian tube and permanent damage to her reproductive system. Neveah Crain died after doctors failed to treat her for sepsis when she was six months pregnant.

In contradiction of the Court, the Department of Health and Human Services rescinded its letter of support for EMTALA compliance in June 2025, further complicating access to medical care for pregnant patients in fetal personhood states. To improve access to essential healthcare, we must address the underlying legal issues that threaten doctors and pregnant patients. In doing so, It is imperative that these discussions address the devastating reality of pregnancy loss experienced by hundreds of thousands of American women every year and the consequences of post-Dobbs policies on those losses.